Department of Counselor Education. Radford University. School Counseling Internship Manual. Department of Counselor Education

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1 2012 Department of Counselor Education Radford University School Counseling Internship Manual Department of Counselor Education College of Education and Human Development B158 Peters Hall P.O. Box 6994 Radford University Radford, VA 24142

2 Table of Contents Letter from the Faculty of Counselor Education...3 An Introduction to School Counseling Internship...4 Forms...4 Application procedures...4 Prerequisites 5 Duel Enrollment..5 Professional Liability Insurance.5 Contracts Learning Contracts..5 K-12 Licensure Plan...5 Standards for Supervised Experiences....6 Goals of Internship Supervision.9 The Nature of Supervision Internship Supervisors Onsite Supervisor Description Qualifications of Onsite Supervisors Responsibilities of Onsite Supervisors University Supervisor Description 11 Specific Responsibilities of the University Supervisor What You Can Expect From Your University Supervisor...12 Requirements and Responsibilities of Internship Students Specific Requirements and Responsibilities of Internship Students Evaluation of Internship Students Ethical Considerations..15 Specific Ethical Considerations for School Counselors Professional Expectations of School Counseling Interns.15 Statement of Academic Honor and Personal Integrity Internship Counselor Contract Information References Appendix A: Part A: Application to Reserve Internship Seat..17 Appendix B: Part B: Clinical Site and Supervisor Selection 18 Appendix C: Supervision Contract...19 Appendix D: Internship Counselor Contract 20 Appendix E: Student Evaluation of Site Supervisor.21 Appendix F: Student Evaluation of Internship Site..23 Appendix G: Supervisor s Mid-Term and Final Evaluation of Counselor Trainee..24 Appendix H: Counselor Trainee Dispositions Evaluation 28 Appendix I: Important Links 31 2

3 School Counseling Internship Manual Internship in School Counseling Department of Counselor Education College of Education and Human Development B158 Peters Hall P.O. Box 6994 Radford University Radford, VA Dear School Counseling Student, Welcome to the culminating experience of your Master s Degree program in counselor education at Radford University. Having completed courses in the foundation of counseling and practicum courses, you are now ready for the internship experience. This manual provides a guide for you concerning the responsibilities and requirements of interns and supervisors as it relates to this internship experience. You are responsible for reading and understanding the specific assignments and expectations of an intern. If you have any questions, please contact your university supervisor for clarification. Internship is your first professional experience as a counselor and it is expected that you will function with the highest standards of professionalism, including physical appearance, adherence to ethical codes, and respect for the students in your care. Functioning with high standards includes maintaining a professional demeanor, not only at the internship site, but also with your university supervisor and fellow interns. It also means you keep an open mind to feedback and suggestions from your supervisors, as well as, you provide meaningful feedback to other interns enrolled in your university supervision group. Internship builds on all other courses you have completed and will help you to expand and refine counseling skills you have developed in earlier practicum experiences. In addition, you are expected to improve your abilities in the areas of case conceptualization and the implementation of integrated and theoretically sound counseling interventions. Please provide suggestions concerning the usefulness of this manual and areas in which it can be improved. Your input will be used in developing future editions of the internship manual. Best wishes, Faculty of the Department of Counselor Education 3

4 Introduction to School Counseling Internship Application Procedures Forms. Students who have completed the prerequisites for internship are expected to submit an internship application to the Department of Counselor Education by the deadline announced each semester. Students should apply the semester preceding the semester they wish to actually participate in the internship. Applications are available online at the counselor education website. The applications must be approved by your advisor and turned in to the department s internship committee on or before the due date to allow for appropriate processing of the application. Application Procedures. 1. Complete Part 1 of the Internship Application, include an unofficial transcript, and turn into your advisor. 2. Complete Part 2 of the Internship Application, include supervisor s resume and turn into the internship committee chair. 3. Complete any other procedures required by your site supervisor and/or university internship professor. Prerequisites. It is the student s responsibility to determine if the necessary prerequisites for internship have been completed. The following courses must be successfully completed before beginning internship: COED 610. Human Growth and Development COED 611. Introduction to Counseling Theories and Techniques COED 612. Professional, Ethical, and Legal Issues in Counseling COED 614. Group Counseling Theories and Techniques COED 641. Practicum: Individual Counseling Techniques COED 642. Practicum: Group Counseling Techniques Please consult your advisor if you have any questions concerning these prerequisites. Dual Enrollment. The Department endorsed the following policies on simultaneous internships, where students desire to complete two internships in one semester: Internship is a sequence of culminating clinical challenges, instructional and supervisory communication, and mentoring to promote experience, applied knowledge, 4

5 understanding, self-awareness, professional responsibility and know-how. Internships are also sequential and developmental in promoting optimal competence of interns. Professional development and clinical competence are acquired over time with prescribed and supervised clinical experiences involving not less than 600 hours of supervised clinical practice. The department affirms that the optimal course of professional development is over a two-semester period involving two 300 clinical hours per three-credit hour internship. Concurrent enrollment in internships of more than three-credits is an exception to departmental policy. Exceptions to this academic policy will require: Achievement of an A in all clinical courses (COED 611, COED 641, COED 642); Recommendations from prior clinical instructors, the faculty advisor, and the chair justifying exceptional clinical proficiency and professional development; and Internship Committee approval of the site and supervisor specifically for simultaneous internship. Professional Liability Insurance You need to obtain liability insurance before you begin your internship. The American Counseling Association provides liability insurance through subcontracting with an insurance company. Rates are very low for students. You can obtain this insurance if you are a member of the American Counseling Association. Membership fees for the American Counseling Association are much lower for students than for regular members. For more information concerning liability insurance, see information in the Counselor Education office in Peters Hall. Contracts You need to complete a contract with your faculty supervisor (see Appendix B). This contract is confirmation that you have read and agree to follow the American School Counselor Association s (ASCA) ethical guidelines and the American Counseling Association s (ACA) ethical guidelines, the internship manual, and that you carry your own malpractice liability insurance. Learning Contract. Students are expected to complete the learning contract (Appendix C) with their on-site supervisor(s). This contract outlines goals, objectives, and duties of the intern, as well as the expectations of the supervisor. This should be completed no later than the first week of internship. Note about learning goals: Although the intern is expected to demonstrate initiative and self-direction at the internship site, he or she needs to work with the on-site supervisor in developing a plan for internship. On-site supervisors may, for example, screen students with whom interns work at the beginning of the internship. Onsite supervisors may ask interns to observe for the first week of the internship. In addition, the on-site supervisor may request that the intern begin a specific type of counseling group or classroom guidance activity at the school. Student interns are expected to adhere to on-site supervisors requests in a professional manner. The K-12 Licensure Plan Students will graduate and meet state requirements for K-12 licensure. Please see Libby Hall in the Dean s office, for licensure information. 5

6 Standards for Supervised Experiences CACREP has developed specific standards for the internship experience which are used by Counselor Education faculty. These standards are based on the following criteria: Students complete a total of 600 hours of supervised internship (300 hours elementary/300 hours secondary) that is begun after successful completion of the student s practica. Internship sites should provide opportunities for students to engage in both individual counseling and group work. The internship is intended to reflect the comprehensive work experience of a professional counselor appropriate to the designated program area. (CACREP Accreditation Standards and Procedures Manual, (2009, p. 15). CACREP standards outline the following requirements for internship: 1. At least 240 clock hours of direct service, including experience leading groups. 2. Weekly interaction that averages one hour per week of individual and/or triadic supervision throughout the internship, usually performed by the onsite supervisor. 3. An average of 1 1/2 hours per week of group supervision provided on a regular schedule throughout the internship and performed by a program faculty member. 4. The opportunity for the student to become familiar with a variety of professional activities and resources in addition to direct service (e.g., record keeping, assessment instruments, supervision, information and referral, in-service and staff meetings). 5. The opportunity for the student to develop program-appropriate audio/video recordings for use in supervision or to receive live supervision of his or her interactions with clients. 6. Evaluation of the student s counseling performance throughout the internship, including documentation of a formal evaluation after the student completes the internship by a program faculty member in consultation with the site supervisor. (CACREP 2009, p. 15,16.) Goals of Internship The internship experience is designed to prepare counseling students to be competent in the use of counseling skills and strategies which are grounded in sound theoretical knowledge and understanding. Specific goals of the internship experience include meeting the following CACREP standards: 1. Foundations: Skills and Practices 1. Demonstrates the ability to apply and adhere to ethical and legal standards in school counseling. 2. Demonstrates the ability to articulate, model, and advocate for an appropriate school counselor identity and program. 2. Counseling, Prevention, and Intervention: Skills and Practices 1. Demonstrates self-awareness, sensitivity to others, and the skills needed to relate to diverse individuals, groups, and classrooms. 6

7 2. Provides individual and group counseling and classroom guidance to promote the academic, career, and personal/social development of students. 3. Designs and implements prevention and intervention plans related to the effects of (a) atypical growth and development, (b) health and wellness, (c) language, (d) ability level, (e) multicultural issues, and (f) factors of resiliency on student learning and development. 4. Demonstrates the ability to use procedures for assessing and managing suicide risk. 5. Demonstrates the ability to recognize his or her limitations as a school counselor and to seek supervision or refer clients when appropriate. 3. Diversity and Advocacy: Skills and Practices 1. Demonstrates multicultural competencies in relation to diversity, equity, and opportunity in student learning and development. 2. Advocates for the learning and academic experiences necessary to promote the academic, career, and personal/social development of students. 3. Advocates for school policies, programs, and services that enhance a positive school climate and are equitable and responsive to multicultural student populations. 4. Engages parents, guardians, and families to promote the academic, career, and personal/social development of students. 4. Assessment: Skills and Practices 1. Assesses and interprets students strengths and needs, recognizing uniqueness in cultures, languages, values, backgrounds, and abilities. 2. Selects appropriate assessment strategies that can be used to evaluate a student s academic, career, and personal/social development. 3. Analyzes assessment information in a manner that produces valid inferences when evaluating the needs of individual students and assessing the effectiveness of educational programs. 4. Makes appropriate referrals to school and/or community resources. 5. Assesses barriers that impede students academic, career, and personal/social development. 5. Research and Evaluation: Skills and Practices 1. Applies relevant research findings to inform the practice of school counseling. 2. Develops measurable outcomes for school counseling programs, activities, interventions, and experiences. 3. Analyzes and uses data to enhance school counseling programs. 6. Academic Development: Skills and Practices 1. Conducts programs designed to enhance student academic development. 2. Implements strategies and activities to prepare students for a full range of postsecondary options and opportunities. 3. Implements differentiated instructional strategies that draw on subject matter and pedagogical content knowledge and skills to promote student achievement. 7

8 7. Collaboration and Consultation: Skills and Practices 1. Works with parents, guardians, and families to act on behalf of their children to address problems that affect student success in school. 2. Locates resources in the community that can be used in the school to improve student achievement and success. 3. Consults with teachers, staff, and community-based organizations to promote student academic, career, and personal/social development. 4. Uses peer helping strategies in the school counseling program. 5. Uses referral procedures with helping agents in the community (e.g., mental health centers, businesses, service groups) to secure assistance for students and their families. 8. Leadership: Skills and Practices 1. Participates in the design, implementation, management, and evaluation of a comprehensive developmental school counseling program. 2. Plans and presents school-counseling-related educational programs for use with parents and teachers (e.g., parent education programs, materials used in classroom guidance and advisor/advisee programs for teachers). 9. Other Goals Included in Internship C.3. Know strategies for helping students identify strengths and cope with environmental and developmental problems. C.5. Understands group dynamics including counseling, psycho-educational, take, and peer helping groups and the facilitation of teams to enable students to overcome barriers and impediments to learning. E.2. Identifies community, environmental, and institutional opportunities that enhance as well as barriers that impede the academic, career, and personal/social development of students. E.3. Understands the ways in which educational policies, programs, and practices can be developed, adapted, and modified to be culturally congruent with the needs of students and their families. G.1. Understands the influence of multiple factors (e.g., abuse, violence, eating disorders, attention deficit hyperactivity disorder, and childhood depression) that may affect the personal, social, and academic functioning of students. M.3. Knows how to build effective working teams of school staff, parents, and community members to promote the academic, career, and personal/social development of students. O.5. Understands the school counselor s role in student assistance programs, school l leadership, curriculum, and advisory meetings. 8

9 Supervision The Nature of Supervision Supervision is one of the most essential aspects of the internship experience, because it provides the intern with information concerning his or her performance, case conceptualization, use of appropriate interventions, and understanding how self-awareness plays a role in the counseling relationship. The faculty of the Department of Counselor Education at Radford University has specific training and appropriate licensure and certification to provide interns with high quality supervision. Borders and Leddick (1987, p. 22) have described critical issues that are used to assess the progress of counselor interns. These eight issues include: 1. Issues of Competence concerning skills, technique, mastery, and ability to take appropriate action. 2. Issues of Emotional Awareness: Knowing oneself, differentiating among one s feelings, and the ability to use one s emotions and reactions as a guide in working with clients. 3. Issues of Autonomy: Developing a sense of self-directedness and personal initiative as a counselor. 4. Issues of Identity: Demonstrating theoretical consistency, conceptual integration, and development of identity as counselor/therapist. 5. Issues of Respect for Individual Differences: Appreciation of individual differences and basic respect for clients and other professionals. 6. Issues of Purpose and Direction: Formulation of treatment plans and developing appropriate long and short-term goals. 7. Issues of Personal Motivation: The meaning attached to being a counselor and understanding its rewarding value. 8. Issues of Professional Ethics: Integrating legal issues, professional standards, and values into one s practice as a counselor. In examining research conducted in the field of internship supervision (Bernard & Goodyear, 1992; Blocher, 1983; Borders & Leddick, 1987) several important factors have been identified which are related to development of competent counselors: 1. Internship supervision is necessary for interns to learn and refine their abilities in the use of counseling skills and treatment planning; 2. A variety of supervisors and internship sites is helpful to an intern s development as a professional; and 3. a developmental learning environment that is characterized by challenge, involvement, support, structure, feedback, innovation, and integration will assist interns in becoming competent practitioners (Borders & Leddick, 1987, p. 30). 9

10 Internship Supervisors Interns have two supervisors who work with them during the internship experience: an on-site supervisor and a university supervisor. Students sign a contract with and are accountable to both supervisors. There is a separate Internship Supervisor Handbook (located on the COED website) that interns are responsible to give to their supervisors. It contains necessary forms and information. On-Site Supervisor The on-site supervisor provides experiences and information that inform the intern of the responsibilities and roles of a school counselor. The on-site supervisor assists the intern in learning the procedures and regulations that are part of the school environment and affect counselor functioning. Student interns need to communicate continually with their on-site supervisors. Interns who wish to confer with an outside agency concerning students, or administer tests, need to receive approval from the on-site supervisor. Students are expected to meet with the on-site supervisor for supervision throughout the semester to determine the quality of an intern s performance, and professional functioning at the internship site. Qualifications of On-Site Supervisors CACREP (2009) standards require that the on-site supervisor meet the following qualifications to supervise counseling interns: 1. A minimum of a master s degree in counseling or a related profession with equivalent qualifications, including appropriate certifications and/or licenses. 2. A minimum of two years of pertinent professional experience in the program area in which the student is enrolled. 3. Knowledge of the program s expectations, requirements, and evaluation procedures for students. 4. Relevant training in counseling supervision (p. 14). Responsibilities of On-Site Supervisors The specific responsibilities of the on-site supervisor are listed below: 1. To plan a minimum of one (1) hour per week of individual supervision, throughout the internship. 2. To provide an atmosphere of trust and support to encourage and enhance the professional growth and maturity of the intern. 3. To provide information and knowledge that is helpful to the intern in effectively carrying out the therapeutic process and learning the roles and responsibilities of a school counselor. 4. To assist the intern in exploring intrapersonal and interpersonal issues which impact (positively or negatively) on his or her counseling performance. 10

11 5. To encourage and facilitate the development of the intern s assessment and counseling skills. 6. To review cases and case materials (via live observation, videotape, or oral report) and to provide feedback regarding case conceptualization and case management. 7. To share clinical expertise and skills in a way which will enhance the intern s learning as well as his or her use of self in the therapeutic process. 8. To respect the individuality of the intern and his or her present level of development. 9. To contact the University Faculty Supervisor when issues develop which impede the supervisory process. 10. To recommend personal counseling or other interventions for the intern when personal issues appear to affect his or her counseling performance. 11. To maintain confidentiality about the supervisory process. 12. To assign readings or other activities to help the intern learn more about the world of school counselors and their responsibilities. 13. To maintain a collaborative supervisory relationship with the intern which encourages continual feedback concerning the intern s progress, and when necessary, re-negotiating of goals. 14. To assist the intern in refining their consultation and coordination skills. 15. To encourage the intern to develop a philosophy of counseling and professional practice as a professional school counselor. 16. To submit at least two (2) written evaluations of the intern; one at the mid-point of the semester, and the other after the intern has completed the internship. University Supervisor A University Supervisor is assigned to each intern and helps the intern assess his or her progress during the internship. The University Supervisor is a faculty member in the Department of Counselor Education who takes the major responsibility for assessing and monitoring the progress of the student during internship. Each regular or adjunct program faculty member who provides individual or group practicum and/or internship supervision must have the following: 1. A doctoral degree and/or appropriate counseling preparation, preferably from a CACREP-accredited counselor education program. 2. Relevant experience and appropriate credentials/licensure and/or demonstrated competence in counseling. 3. Relevant supervision training and experience. (CACREP 2009, p. 14). 11

12 Specific Responsibilities of the University Supervisor The specific responsibilities of the university supervisor are listed below: 1. To meet weekly with the intern for supervision. 2. To provide training concerning the scope and standards of clinical practice. 3. To review counseling tapes and provide feedback and recommendations concerning case conceptualization, counseling interventions, and counselor/student relationship issues. 4. To work collaboratively with the intern and on-site supervisor to remediate deficiencies in counseling skills or knowledge areas of the intern. 5. To help interns further refine use of counseling techniques and skill level. 6. To assist interns in developing an integrated philosophy and style of counseling. 7. To encourage the use of consultation skills among interns during group supervision as a method of providing feedback to each other concerning internship cases. What You Can Expect From Your University Supervisor The University Supervisor expects interns to familiarize themselves with the requirements of internship and seek clarification if needed. Students will meet once a week with the University Supervisor for group supervision. Individual supervision meetings may be scheduled as needed. Group supervision sessions last from 1 ½ to 2 hours. Students are encouraged to seek assistance from their University Supervisor when needed in addition to scheduled supervision meetings. Your supervisor has your best interests in mind and will provide experiences, which help you grow as a counseling professional. This means that your supervisor may ask you to modify your approach with a specific student, seek counseling to work on personal issues that impede your work with a client, challenge you to more clearly articulate your philosophy as a counselor, and provide feedback which might produce some discomfort for you. You can also be assured that your supervisor will provide the support, assistance, and concern you need to develop your abilities within an atmosphere of trust and respect. It is a collaborative relationship. 12

13 Requirements and Responsibilities of Internship Students Internships carry variable credits from three to nine academic credits. This means that a school counseling intern may register for up to nine hours of internship, during the course of their academic program. Each threecredit internship involves completing 300 hours of supervised practical experience in an appropriate school setting. Two 300-hour internships are required to complete a master s in school counseling. The following list describes specific parameters of internship and the responsibilities of the intern. Specific Requirements and Responsibilities of Internship Students 1. Complete 600 hours of school internship. 2. A minimum of 240 hours at the internship site must involve direct contact (classroom guidance, individual or group counseling). The remaining 360 hours at the internship site should be spent in other activities that help you learn the responsibilities and roles of counselors, including the academic, personal/social and career development of students. 3. Each internship lasts 15 weeks (duration of a semester) which means students need to spend at least twenty hours per week at the internship site. It is suggested that students begin their internships at the beginning of the first week of a semester to insure that they obtain the needed hours for internship. 4. The intern meets with the University Supervisor once a week for group supervision. 5. The intern has a formal supervision meeting with the On-Site Supervisor for one hour per week. 6. Interns will be expected to evaluate their on-site and university supervisors at the conclusion of the internship. 7. The school placement has a different calendar than Radford University. There are different breaks, start and end dates, and holidays. As a school counseling intern, you are expected to follow both calendars. You are a professional in the school and need to be there when it is open. Evaluation of Internship Students To successfully complete internship, students are asked to fulfill specific assignments that are designed to assist them in developing the skills, knowledge, and self-awareness needed to function as a professional counselor. It is a process that will, in most cases, result in the development of competent professional counselors. Your efforts during the internship process will determine the level of accomplishment you have achieved at the end of internship. The following list describes specific assignments, which will be used to determine your grade for the internship. Grades are assigned using an A-F scale and are based on the quality of your work in the following areas: 1. Attending and actively participating in individual and group supervision meetings. 2. Providing your university supervisor with videotapes of individual and group counseling sessions throughout the length of the internship, if requested by the university supervisor. The number of videotapes to be provided will be determined by the university supervisor. a. Videotapes need to be reviewed and set before supervision sessions to conserve supervisor s time. b. Videotapes should be of good quality (audible, good lighting) so that they can be used to assess the intern s performance and the client s behavior. c. Place the camera so that both client and counselor are visible. d. It will be helpful to tape several clients and then choose which ones to bring to supervision. 13

14 e. It is suggested that you bring both tapes in which you feel you present your best in skills and also tapes of sessions in which you feel you need assistance (sessions where you feel stuck or unsure). Your university supervisor may request specific kinds of tapes from you. f. Record the entire session with a student from the initial contact to the termination of the session. g. Videotapes will be evaluated for the following reasons: to assess an intern s progress in demonstrating basic and advanced counseling skills, conceptualizing student concerns, demonstrating professional behavior with clients, providing an appropriate treatment plan, and demonstrating good clinical judgment. 3. Keeping accurate records which include daily logs and documentation of supervision. This will be specific to the requirements of your professor. 4. Documenting the specific activities of your internship and keeping accurate hours that specify the time you spent in counseling and other responsibilities at the internship site. 5. Preparing a capstone project, which may include a case study, transcription, or research paper, for each 300 hour internship? Your university supervisor will provide more information concerning this assignment. 6. Demonstrating advanced counseling skills and techniques in work with clients. 7. Demonstrating the ability to apply counseling theory in assessing and planning interventions with clients. 8. Submitting mid-semester and final On-Site Supervisor Evaluation Rating Forms of intern and the Intern Evaluation of On-Site Supervisor, and Intern Evaluation of University Supervisor. These forms are in Appendix C of this manual. 9. An intern will be assessed in terms of the quality and thoroughness of work submitted to the University Supervisor. There are rare incidents when an internship ends early. Early separation may be site or student initiated, or a combination of both. The goal of an early separation is to make it a positive learning experience for the student and to maintain positive programmatic working relationships with the site. Permission for early separations is granted only after other efforts to address the situation have been unsatisfactory. In the event an early separation is appropriate, it will occur with the mutual consent of all parties and requires active consultation and participation of the supervising faculty member and/or clinical supervisor. Should problems arise, we strive to maintain positive working environments for the student and a positive working relationship with the site. Students may be removed from internship for difficulties in academic performance. Academic performance includes demonstrated knowledge, technical and interpersonal skills, attitudes, and professional character. Students may also be removed from internship based on evidence of incapacity, incompetence, or unethical behavior. These are defined as: Persistent limitations in interpersonal or social relationships characterized by frequent disruptions in collegial and/or client-therapist relationships, due to factors such as withdrawal, conflicts, inappropriateness, aggressiveness, or hostility; and Persistent inability to carry out the professional functions of a counselor, characterized by frequent inability to be able to complete complex skills and techniques of the profession without assistance or direction. 14

15 Ethical Expectations One of the most important aspects of internship is the adherence to the ethical standards of the both ASCA and ACA. Specific Ethical Considerations for School Counselors 1. Each intern is responsible for protecting the confidentiality of students/clients. Use only initials on written documents concerning students (case studies, tape analysis forms). 2. Obtain written permission from the student and parents or guardians of students to tape counseling sessions. 3. Interns must make sure that they obtain adequate consultation when working with student problems outside of their range of competencies. Professional Expectations of School Counseling Interns. Students are expected to conduct themselves as professionals at their sites. They should familiarize themselves with the expectations of staff at their site and adhere to these expectations. At all times, students are expected to maintain appropriate confidentiality regarding activities at the site and to adhere to the ethical guidelines set forth by the American Counseling Association and the American School Counselor Association. Students should carry out the duties and responsibilities of their internship agreement to the best of their ability and meet with their supervisor to modify any aspect of the agreement which may become problematic. Students are expected to keep their supervisor informed of their activities, needs, concerns, and accomplishments with regard to the practicum. Statement of Academic Honor and Personal Integrity Students enrolled in internship are also expected to accept the following statements of minimal standards of personal and academic integrity and honesty approved by Radford University and the Department of Counselor Education: By accepting admission to Radford University, each student makes a commitment to understand, support, and abide by the University Honor Code without compromise or exception. Violation of academic integrity will not be tolerated. This class will be conducted in the strict observance of the Honor Code. Refer to your Student Handbook for further information and clarification. Internship Counselor Contract Interns must sign the Internship Counselor Contract in this manual to document their understanding of the responsibilities and requirements of internship, and return this form to the university supervisor. 15

16 References Blocher, D. H. (1983). Toward a cognitive developmental approach to counseling supervision. The Counseling Psychologist, 11, Borders, L. D., & Leddick, G. (1987). Handbook of counseling supervision. Alexandria, VA: American Association for Counseling and Development. CACREP Accreditation Manual. CACREP 2009 Standards. 16

17 Appendix A Radford University: Department of Counselor Education Internship Part A: Application to Reserve Internship Seat (Due Spring Semester Second Friday in February) Personal Information Name: Student Number: Address: Street City State Zip Phone (H): Phone (W): Academic Information Advisor: Concentration: Radford University Main Campus Abingdon Campus My expected date of graduation is. ***Please attach unofficial transcript to application. I have met with my advisor, who confirms that I will have the necessary coursework completed. (faculty initials) Internship Information Please complete the following information for your Internship seat reservations: 1 st Internship When: Semester/Year 2 nd Internship When: Semester/Year Site Information School Internships: The College will work to consider your preferences for placements 1) School System/Name: Semester: Grade Level: 2) School System/Name: Semester: Grade Level: 3) School System/Name: Semester: Grade Level: 4) School System/Name: Semester: Grade Level: Signatures Student Date Faculty Advisor (by signing this, the advisor agrees the student has met the requirements for internship.) Date 17

18 Intern s Information Appendix B Radford University: Department of Counselor Education Internship Part B: Clinical Site and Supervisor Selection Intern s Name: Student Number: Address: Street City State Zip Phone (H): Phone (W): Semester and Year of Internship Internship Site Information Internship Site: Address: Street City State Zip Supervisor s Information: Supervisor: Phone: Graduate Institution: Year: Degree: Major: Licensure & Certification Status Professional Licensure: Professional Licensure: State: # State: # Certification: Organization: Certification: Organization: Professional Experience Current Position Title: Previous Position Title: Years: Years: 18

19 Appendix C Radford University: Department of Counselor Education Internship Supervision Contract The faculty of Radford University s Counselor Education Department thanks you for agreeing to supervise our Internship student. To insure a complete understanding of the requirements of our program, please check that you have read and agree to the following: I understand that this internship student requires 300 hours of work with 120 of those hours in direct client contact for this semester. I agree to meet with this internship student for one hour per week for supervision. I agree to participate in an RU faculty site visit. I will complete the necessary student evaluations at mid-term and final Signatures (If this is the first time that you are supervising an RU Intern, please attach your current Resume.) On-site Supervisor Date Student Date 19

20 Appendix D Radford University: Department of Counselor Education Internship Internship Counselor Contract The intern is to sign and submit this Internship Counselor Contract to the assigned University Supervisor during the first week of internship. Please read the contract listed below and use it as a guide for your internship experience. 1. I have read, understand, and agree to follow the ethical standards of the American School Counselor Association and the American Counseling Association (ACA). 2. I have read the school internship manual and understand the requirements of this internship. 3. I further understand that I am responsible and expected to attend all supervision sessions, fully prepared as specified in the course outline. 4. I currently carry my own personal liability insurance. Please attach copy of policy face sheet. Counselor Intern Signature Date University Supervisor s Signature Date 20

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